步行训练联合Buerger运动改善住院老年高血压病人早餐后低血压的效果

Effect of ambulation training combined with Buerger movement on improving postprandial hypotension after breakfast in elderly inpatients with hypertension

目的 观察步行训练联合Buerger运动改善住院老年高血压病人早餐后低血压(PPH)的效果。方法 选择南京市胸科医院心血管内科住院的老年高血压病人为研究对象,运用PDCA(Plan-Do-Check-Action)的管理方法,分析2021年11月15日至2022年4月17日住院的33例病人(对照组)PPH发生率高的原因,指导2022年5月5日至10月31日住院的38例病人(观察组)早餐后实施步行联合Buerger运动。比较PDCA实施前后2组病人早餐后30、60、90、120 min PPH的发生率,以及2组病人对PPH知识知晓、早餐后主动运动情况。比较项目实施前后护士对PPH知识知晓、宣教落实的情况。结果 2组病人性别、年龄、SBP差异均无统计学意义(P>0.05)。观察组早餐后PPH的发生率明显低于对照组(15.79%比45.45%,P=0.006)。观察组病人对PPH的概念、易患人群、发生时间的知晓率及餐后主动运动率明显高于对照组(P均<0.01)。项目实施后,护士对PPH的概念、血压下降特点、发生时间、非药物预防措施的知晓率及PPH宣教落实率明显高于实施前,差异均有统计学意义(P<0.05或P<0.01)。结论 步行联合Buerger运动能有效降低住院老年高血压病人早餐后低血压的发生,PDCA管理法能提高病人及护士对PPH知识的知晓率,促进早期识别、早期干预,将PPH的危害性控制在最低程度。

Objective To observe the effect of ambulation training combined with Buerger movement on improving postprandial hypotension(PPH)after breakfast in the elderly inpatients with hypertension.Methods The elderly hypertensive patients hospitalized in Department of Cardiovascular Internal Medicine of Nanjing Chest Hospital were selected as the research subjects.The Plan-Do-Check-Action(PDCA)management method was used to analyze the reasons for the high incidence rate of PPH after breakfast in 33 patients(control group)who were hospitalized from November 15,2021 to April 17,2022,and 38 patients(observation group)who were hospitalized from May 5 to October 31,2022 received ambulation training combined with Buerger movement after breakfast.The incidence rate of PPH 30,60,90,and 120 min after breakfast,the awareness of PPH knowledge,and the proportion of active exercise after breakfast were compared between the two groups.The awareness of PPH knowledge and implementation rate of propaganda and education among the nurses before and after project implementation were compared.Results There were no significant differences in gender,age and systolic blood pressure(SBP)between the two groups(P>0.05).The incidence rate of PPH after breakfast in the observation group was significantly lower than that in the control group(15.79%vs 45.45%,P=0.006).The awareness rates of PPH concept,susceptible population and occurrence time,and the proportion of active exercise after breakfast in the observation group were significantly higher than those in the control group(all P<0.01).After the implementation of the project,the awareness rates of PPH concept,characteristics,occurrence time and non-drug prevention measures,and the implementation rate of PPH propaganda and education among the nurses were significantly improved(P<0.05 or P<0.01).Conclusions Ambulation training combined with Buerger movement can effectively reduce the occurrence of PPH after breakfast in the elderly inpatients with hypertension,and the PDCA program can improve the awareness rate of PPH knowledge among the patients and nurses,conduce to the early identification and intervention,and minimize the harm of PPH.